Pain managementPub Date : 2026-10-01Epub Date: 2026-06-06DOI: 10.1080/17581869.2026.2682470
Camas Curran, Evan J Hernandez, Jennifer Hudnall, Jaspinder Sra, Max E Davis
{"title":"Effect of intraoperative ketamine on pain, opioid use, and psychological recovery in orthopedic trauma patients (KOPM trial): protocol for a randomized, single-blind trial.","authors":"Camas Curran, Evan J Hernandez, Jennifer Hudnall, Jaspinder Sra, Max E Davis","doi":"10.1080/17581869.2026.2682470","DOIUrl":"10.1080/17581869.2026.2682470","url":null,"abstract":"<p><strong>Background: </strong>Orthopedic trauma patients frequently struggle with pain control, prolonged opioid use, and psychiatric co-morbidities, including depression and post-traumatic stress disorder (PTSD). Current treatment strategies inadequately address both pain and psychological recovery. Ketamine, an NMDA receptor antagonist with analgesic and psychotropic properties, has shown promise in surgical and psychiatric populations but has not been evaluated in polytraumatized orthopedic patients.</p><p><strong>Objectives: </strong>This study evaluates ketamine's effectiveness on postoperative pain measured by the Visual Analog Scale (VAS), opioid consumption converted to morphine milligram equivalents (MME), and psychological recovery assessed with the Patient Health Questionnaire-9 (PHQ-9) and PTSD Checklist for DSM-5 (PCL-5).</p><p><strong>Methods: </strong>In this prospective, randomized, single-blind, active comparator study, 90 adults aged 18-65 undergoing operative fixation for orthopedic injuries at a Level I Trauma Center will receive either ketamine (0.5 mg/kg IV bolus) or standard general anesthesia without ketamine. Participants remain blinded to treatment, while surgical, anesthesia, and postoperative clinical care teams are unblinded. Outcomes will be measured at 1-7 days, 2-3 weeks, 6 weeks, 3 months, and 6 months postoperatively.</p><p><strong>Discussion: </strong>This is the first randomized controlled trial to evaluate intraoperative ketamine for both physical and psychological recovery in orthopedic trauma patients, addressing a critical gap in perioperative trauma care.</p><p><strong>Clinical trial registration: </strong>The www.clinicaltrials.gov identifier is NCT06903819.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1063-1072"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148194881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain managementPub Date : 2026-10-01Epub Date: 2026-08-06DOI: 10.1080/17581869.2026.2713531
Mert Zure, Merve Damla Korkmaz
{"title":"Ultrasound-guided hypertonic dextrose prolotherapy for chronic coccydynia: a comparative study of clinical outcomes and functional improvement.","authors":"Mert Zure, Merve Damla Korkmaz","doi":"10.1080/17581869.2026.2713531","DOIUrl":"10.1080/17581869.2026.2713531","url":null,"abstract":"<p><strong>Introduction: </strong>Coccydynia is characterized by persistent tailbone pain that significantly impairs quality of life. Despite conservative treatments, many patients experience inadequate symptom relief. Prolotherapy, a regenerative injection technique for chronic musculoskeletal pain, shows promise; however, its efficacy for coccydynia has not been evaluated in controlled comparative studies. To the best of the authors' knowledge, this is among the first such studies.</p><p><strong>Areas covered: </strong>This retrospective comparative study evaluated 56 patients with primary chronic coccydynia refractory to conservative management. Twenty-nine patients received ultrasound-guided 10% dextrose prolotherapy combined with therapeutic exercises and patient education; 27 patients received exercises and education alone. Mean pain duration was 20.7 ± 17.3 months (prolotherapy) and 26.9 ± 17.3 months (control). Primary outcomes were pain intensity and functional disability at baseline, 1-month, and 3-month follow-up. Secondary outcomes comprised the Paris Functional Coccydynia Impact Questionnaire.</p><p><strong>Expert opinion: </strong>Ultrasound-guided dextrose prolotherapy combined with therapeutic exercises demonstrated superior efficacy compared to exercises alone. The prolotherapy group achieved a 73% pain reduction at 3 months versus 26% in controls. An 82.8% clinical response rate and 37.9% complete pain resolution were observed, with a favorable safety profile. These results support prolotherapy as an effective, minimally invasive option for chronic coccydynia following failed conservative management.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1123-1129"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain managementPub Date : 2026-10-01Epub Date: 2026-09-18DOI: 10.1080/17581869.2026.2736034
Sibel Küçük, Sezer Avcı, Ümran Sevil
{"title":"The effect of stress ball use during the intrapartum period on labor pain and childbirth experience in primiparous women: a randomized controlled trial.","authors":"Sibel Küçük, Sezer Avcı, Ümran Sevil","doi":"10.1080/17581869.2026.2736034","DOIUrl":"10.1080/17581869.2026.2736034","url":null,"abstract":"<p><strong>Aim: </strong>This study examined the effect of stress ball use during the intrapartum period on labor pain intensity and childbirth experience in primiparous women.</p><p><strong>Methods: </strong>This two-arm, parallel-group randomized controlled trial was conducted between October and December 2025 in the delivery unit of a public hospital in Türkiye. Sixty-six primiparous women were randomized in a 1:1 ratio to the intervention (<i>n</i> = 33) or control group (<i>n</i> = 33). Outcome analyses included 60 participants with available outcome data (intervention, <i>n</i> = 29; control, <i>n</i> = 31). Women in the intervention group used a stress ball during uterine contractions, whereas the control group received routine intrapartum care. Labor pain intensity was assessed using the Visual Analog Scale (VAS) during the latent, active, and transition phases, and childbirth experience was assessed postpartum using the Childbirth Experience Questionnaire (CEQ).</p><p><strong>Results: </strong>Pain intensity during the transition phase was significantly lower in the intervention group than in the control group (<i>p</i> = 0.001; Cohen's d = -0.89), whereas no significant between-group differences were observed during the latent or active phases (<i>p</i> > 0.05). The intervention group had a significantly higher total CEQ score (<i>p</i> < 0.001; Cohen's d = 1.08), with higher scores for birth process (<i>p</i> = 0.001; Cohen's d = 0.93) and agreement in decisions (<i>p</i> < 0.001; Cohen's d = 2.11).</p><p><strong>Conclusion: </strong>Stress ball use was associated with lower overall labor pain, with a significant between-group difference observed during the transition phase, and with a more positive childbirth experience.</p><p><strong>Trial registration: </strong>www.clinicaltrials.gov identifier NCT07011355.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1149-1159"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain managementPub Date : 2026-10-01DOI: 10.1080/17581869.2026.2738449
Jordi Miró, Adrià Miró, Guillermo Ceniza-Bordallo, Juan P Sanabria-Mazo
{"title":"Persistent and recurrent musculoskeletal pain in young athletes: an overlooked biopsychosocial determinant of return to sport trajectories - a focused narrative review.","authors":"Jordi Miró, Adrià Miró, Guillermo Ceniza-Bordallo, Juan P Sanabria-Mazo","doi":"10.1080/17581869.2026.2738449","DOIUrl":"https://doi.org/10.1080/17581869.2026.2738449","url":null,"abstract":"<p><strong>Introduction: </strong>Persistent and recurrent musculoskeletal pain is common in young athletes, yet its role in recovery and return to sport (RTS) decision-making remains insufficiently acknowledged. In youth sport, pain is often normalized or viewed primarily through an injury-centered lens, despite its potential to shape function, participation patterns, and athletic trajectories over time.</p><p><strong>Areas covered: </strong>This focused narrative review aimed to (1) synthesize current evidence on persistent and recurrent musculoskeletal pain in young athletes and (2) propose a developmentally informed biopsychosocial framework for understanding its implications for RTS. Electronic searches were conducted in PubMed, PsycINFO, and SPORTDiscus for studies published from 1 January 2006, through 28 February 2026, supplemented by backward and forward citation tracking and targeted hand-searching of reference lists. It integrates evidence on definitions, prevalence, clinical presentation, psychosocial and contextual factors, functional interference, and RTS decision-making, conceptualizing ongoing pain as an overlooked determinant of RTS trajectories.</p><p><strong>Expert opinion/commentary: </strong>In young athletes, pain should not be treated as a peripheral symptom or addressed only when recovery is delayed. More informed RTS decisions require attention not only to physical recovery markers, but also to how pain is experienced, interpreted, and managed throughout recovery. A developmentally informed biopsychosocial perspective may support earlier recognition, safer return decisions, more stable participation, and better long-term health outcomes.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1-12"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain managementPub Date : 2026-10-01Epub Date: 2026-06-16DOI: 10.1080/17581869.2026.2688379
Anna Anselmo, Francesco Corallo, Maria Pagano, Davide Cardile, Daniela Floridia, Rossana Panasiti, Giuseppe Micali, Lilla Bonanno, Rocco Salvatore Calabrò, Irene Cappadona
{"title":"Central sensitization across nociceptive, neuropathic, and mixed chronic pain: a multidimensional longitudinal study protocol integrating neurophysiological, cognitive, and psychological measures.","authors":"Anna Anselmo, Francesco Corallo, Maria Pagano, Davide Cardile, Daniela Floridia, Rossana Panasiti, Giuseppe Micali, Lilla Bonanno, Rocco Salvatore Calabrò, Irene Cappadona","doi":"10.1080/17581869.2026.2688379","DOIUrl":"10.1080/17581869.2026.2688379","url":null,"abstract":"<p><p>Chronic pain represents a major clinical and public health challenge due to its multidimensional nature and frequent resistance to treatment. Beyond the traditional distinction between nociceptive and neuropathic pain, increasing evidence highlights central sensitization as a key transdiagnostic mechanism underlying pain persistence, symptom severity, and reduced treatment response. However, longitudinal studies integrating neurophysiological, cognitive, psychological, and behavioral dimensions across different chronic pain phenotypes remain limited. This study describes a prospective, longitudinal observational protocol aimed at investigating central sensitization in patients with nociceptive, neuropathic, and mixed chronic pain. Participants will be assessed at baseline and at 12-month follow-up using both psychometric and neurophysiological measures, including the Central Sensitization Inventory and laser-evoked potentials, together with standardized evaluations of pain intensity, cognitive functioning, psychological distress, pain self-efficacy, patient engagement, and medication adherence. By combining subjective and objective measures of central sensitization within a multidimensional framework, this study aims to improve the characterization of chronic pain phenotypes and to support a more precise, mechanism-based, and personalized approach to pain management in clinical practice<b>Clinical trial registration:</b> The http://www.ClinicalTrials.gov identifier is NCT07321080.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1083-1091"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain managementPub Date : 2026-10-01DOI: 10.1080/17581869.2026.2738419
Steven P Cohen, Roman Smolynets, Jordan Wood, Vinita Singh, Harold J Gelfand, Edward J Park, Stephen E Rodriguez, Stacey Harcum, Elsa Ermer, Lauren D Dodd, David B King, Jason Ross, Dost Khan, Antoun M Nader, Paul F Pasquina, David L Brody
{"title":"Multi-center, randomized controlled efficacy and comparative-effectiveness study evaluating ketamine, stellate ganglion blocks, combination treatment, and sham treatments for posttraumatic stress disorder and traumatic brain injury-associated headache: a study protocol.","authors":"Steven P Cohen, Roman Smolynets, Jordan Wood, Vinita Singh, Harold J Gelfand, Edward J Park, Stephen E Rodriguez, Stacey Harcum, Elsa Ermer, Lauren D Dodd, David B King, Jason Ross, Dost Khan, Antoun M Nader, Paul F Pasquina, David L Brody","doi":"10.1080/17581869.2026.2738419","DOIUrl":"https://doi.org/10.1080/17581869.2026.2738419","url":null,"abstract":"<p><strong>Background: </strong>Posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) are conditions that share common mechanisms and are highly co-prevalent with each other and chronic pain. This pragmatic study will compare ketamine infusions to stellate ganglion blocks (SGB), their combination, and a placebo-sham-controlled arm.</p><p><strong>Methods: </strong>A double-blind study conducted at 3 U.S. and Ukrainian sites will be performed. Two hundred ten patients with PTSD and/or TBI-associated headache will be allocated in a 2:2:2:1 ratio to receive SGB/placebo ketamine, ketamine/sham SGB, ketamine/SGB, and placebo/sham. The bivariate co-primary outcome will evaluate change in Headache Impact Test and PTSD Checklist depending on diagnosis, at 4 weeks. Participants who experience a positive binary outcome will remain in the study through 6 months or until their outcome becomes negative.</p><p><strong>Discussion: </strong>Because PTSD and TBI have no discrete pathophysiological mechanisms and are co-prevalent with pain and psychopathology, they are associated with poor outcomes, polypharmacy, and high non-adherence rates, indicating a need for minimally invasive treatments that obviate these barriers. Whereas both therapies have evidence underpinning efficacy, results in clinical trials are conflicting. This study will provide real-world evidence in generalizable populations on the efficacy and comparative-effectiveness of ketamine and SGB, alone and in combination, with the possibility of changing clinical guidelines.</p><p><strong>Clinical trial registration: </strong>www.clinicaltrials.gov identifier is NCT06608277.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1-11"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain managementPub Date : 2026-10-01Epub Date: 2026-07-21DOI: 10.1080/17581869.2026.2707412
Chad E Cook, William R Reed
{"title":"Advancing non-pharmacological and non-surgical management of musculoskeletal pain.","authors":"Chad E Cook, William R Reed","doi":"10.1080/17581869.2026.2707412","DOIUrl":"10.1080/17581869.2026.2707412","url":null,"abstract":"","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1057-1059"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain managementPub Date : 2026-10-01Epub Date: 2026-07-17DOI: 10.1080/17581869.2026.2702382
Thanin Asawavichienjinda, JianLi Wang
{"title":"Psychiatric and medical comorbidities in patients with migraine before and during the COVID-19 pandemic in Thailand: a retrospective comparative cohort study of two different clinical groups.","authors":"Thanin Asawavichienjinda, JianLi Wang","doi":"10.1080/17581869.2026.2702382","DOIUrl":"10.1080/17581869.2026.2702382","url":null,"abstract":"<p><strong>Aim: </strong>Psychiatric and medical comorbidities are common in migraine and worsen pain burden and treatment outcomes. We examined the prevalence of comorbidities overall, before and during the COVID-19 pandemic, across migraine subtypes, and identified associated risk factors.</p><p><strong>Methods: </strong>This retrospective comparative cohort study included patients diagnosed with migraine according to the International Classification of Headache Disorders at a tertiary headache center in Thailand. Clinical data were obtained from standardized case record forms and electronic medical records. Comorbidities were self-reported at the initial visit and verified by documented diagnoses. Group differences were analyzed using chi-square or independent t-tests. Multivariable logistic regression identified independent risk factors.</p><p><strong>Results: </strong>Of the 572 patients, 29.9% had migraine with aura. Overall, 67.7% had at least one comorbidity, and 8.0% had psychiatric comorbidities. During the COVID-19 pandemic, overall and psychiatric comorbidities were more prevalent than in the pre-2020 period (79.4% vs. 66.2% and 17.4% vs. 6.9%, respectively). Chronic migraine was independently associated with comorbidities (adjusted OR 1.67, 95% CI 1.11-2.51), whereas the pre-COVID-19 period was associated with lower odds.</p><p><strong>Conclusions: </strong>Comorbidities are highly prevalent in migraine, particularly during the COVID-19 pandemic and among patients with chronic migraine. Integrated pain management and routine psychiatric screening may improve comprehensive care.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1141-1148"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The effect of craniocervical flexor exercise on chronic neck pain: a systematic review and meta-analysis.","authors":"Norollah Javdaneh, Esmaeil Mozafaripour, Ali Mohammadi, Anahita Younesiramedani, Azadeh Noorian Mohammadabadi, Arash Shams","doi":"10.1080/17581869.2026.2694373","DOIUrl":"10.1080/17581869.2026.2694373","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review and meta-analysis evaluated the effectiveness of craniocervical flexor (CCF) exercises on pain intensity, functional disability, muscle endurance, muscle strength, cervical flexion range of motion, and craniovertebral angle (CVA) in patients with chronic neck pain (CNP).</p><p><strong>Methods: </strong>Twenty-five randomized controlled trials (1,166 participants) were included. Methodological quality was assessed using the PEDro scale, and risk of bias via the RoB 2 tool. Meta-analysis was performed using standardized mean differences (SMD) from random effects models.</p><p><strong>Results: </strong>Compared to other interventions, CCF exercises produced a moderate-to-large reduction in pain (SMD: -0.97) and moderate improvement in disability (SMD: -0.50). Combining CCF with other interventions yielded a very large pain reduction (SMD: -1.70). Muscle endurance showed a very large increase (SMD: 1.55), muscle strength a moderate increase (SMD: 0.60), cervical flexion range of motion substantial improvement (SMD: 0.83), and CVA moderate improvement (SMD: 0.51).</p><p><strong>Conclusion: </strong>CCF exercises, alone or combined, appear to improve pain, function, and forward head posture in CNP. However, due to substantial heterogeneity, variable risk of bias, and diverse protocols, findings are suggestive rather than definitive. Higher-quality RCTs with standardized protocols are needed to confirm these clinically promising results.</p><p><strong>Protocol registration: </strong>www.crd.york.ac.uk/prospero identifier CRD420251176050.</p>","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1171-1181"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148318696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pain managementPub Date : 2026-10-01Epub Date: 2026-04-20DOI: 10.1080/17581869.2026.2660144
Daniel J McCoy, Logan M Olson, Neil B Sandson, Catherine Marcucci
{"title":"Autoinduction and suzetrigine: potential clinical implications.","authors":"Daniel J McCoy, Logan M Olson, Neil B Sandson, Catherine Marcucci","doi":"10.1080/17581869.2026.2660144","DOIUrl":"10.1080/17581869.2026.2660144","url":null,"abstract":"","PeriodicalId":20000,"journal":{"name":"Pain management","volume":" ","pages":"1061-1062"},"PeriodicalIF":1.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147723648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}